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BackgroundThe prevalence of essential hypertension complicated with obstructive sleep apnea hypopnea syndrome (OSAHS) has been increasing year by year. However, due to the differences in medical conditions and lack of clinical understanding in different regions of China, the diagnosis of hypertension complicated with OSAHS is still insufficient. Relevant studies have shown that the pathogenesis of hypertension complicated with OSAHS is closely related to the ectopic accumulation of fat and insulin resistance.ObjectiveThis study attempted to analyze the relationship between OSAHS and abdominal visceral adipose tissue (VAT) and homeostasis model assessment of insulin resistance (HOMA-IR) , and their predictive value for hypertension complicated with OSAHS.MethodsTwo hundred and thirty-four patients with essential hypertension treated at hypertension center of Yan'an Hospital of Kunming Medical University from January 2019 to July 2020 were enrolled in the study. The HOMA-IR of the enrolled patients was calculated by polysomnography, VAT measurement, parallel glucose tolerance and insulin release experiments. According to the AHI level, 27 patients were divided into hypertension group (AHI

Xiaoke Pills are Chinese and Western medicine compound preparations with effects of nourishing kidney and Yin,and supplementing Qi and promoting fluid. It is widely used in clinical treatment of type 2 diabetes( Qi and Yin deficiency syndrome),and continuously included in 2010,2013 and 2017 editions of Chinese prevention guide for type 2 diabetes. For the purpose of accurate positioning and rational use in clinic,it is necessary to further define the curative effect,indications,medication precautions and contraindications of Xiaoke Pills,in order to improve medication safety. This consensus was reached by reference of international clinical guidelines and expert consensus approach based on clinical evidence-based evidence,expert experience and standard specification. The evidence-based evaluation was oriented to clinical problems summarized by no less than 200 front-line clinical physicians in two rounds.GRADE system was adopted for quality classification and evaluation of the evidences,and then the nominal group method was used to form consensus recommendations or suggestions. This consensus defined the curative effect advantages,target users,dosage,administration method,contraindications and precautions of Xiaoke Pills,and provided valuable reference for the clinical use of the drug. Thisconsensus still needs to be updated and revised based on new clinical problems and evidence-based evidence in practical application in the future.

The application of classical formula in the treatment of diabetes has a long history. Zhang Zhongjing set up a special chapter on consumptive thirst in Synopsis of the Golden Chamber,listing Baihu Jia Renshen Decoction for exuberant heat in the lung and stomach,dual deficiency of Qi and Yin syndrome,and Shenqi Pills for kidney Qi deficiency syndrome. However,the clinical application is not limited to them. In this study,formulas of Huanglian,Dahuang,Chaihu,Gualougen,Lingzhu,Huangqi and Dihuang are listed as the main therapeutic methods for diabetes mellitus,with effects in clearing heat,dredging the bowels and purging turbid,clearing depression and dispersing knots,nourishing Yin and quenching thirst,invigorating spleen and draining dampness,supplementing Qi and tonifying deficiency,nourishing Yin and tonifying kidney,which have the advantages for the treatment of diabetes and its complications. Based on accurate differentiation of symptoms and signs,consideration shall be given to both " of diseases and syndromes",while emphasis shall be given to the " main symptoms",so as to flexibly apply classical formula and expand the scope of application.

Objective: To explore the biological function of BMAL1 in human acute myeloid leukemia by means of the HL-60 cell line in whica circadian gene BMAL1 was konocked-out by the CRISPR/Cas9 technology., Methods: Two sgRNAs for BMAL1 were designed and the PX459 knockout vectors containing the sgRNA were constructed. The activity of 2 sgRNAs was detected by T7 endonuclease I. the BMAL1 knocked out HL-60 cells were prepared by transient transfection of the target vectors into the cells. Western blot was used to detect the expression of BMAL1 protein. The apoptosis of the targeted cells was detected by flow cytometry. The proliferation status of the cells was assessed by the CCK-8 assay., Results: The PX459-sgRNA vectors were successfully constructed and screened to assure the activity of the targeting vector. It was found that the expression of BMAL1 protein was not detected in BMAL1-knocked out HL- 60 cells. Further, it was shown that BMAL1 knockdout could promote the apoptosis of HL-60 cells and inhibit the cell proliferation ability., Conclusion: BMAL1 knocked out HL-60 cells have bean successfully established using the CRISPR/Cas9 gene editing technique, and BMAL1 knockout can promote the HL-60 cell apoptosis and inhibit its proliferation.These result reveal the biological role of the BMAL1 circadian gene in acute myeloid leukemia.

As an outstanding representative of traditional Chinese medicine(TCM) prescriptions accumulated from famous TCM doctors' clinical experiences in past dynasties, classical TCM excellent prescriptions (cTCMeP) are the most valuable part of TCM system. To support the research and development of cTCMeP, a series of regulations and measures were issued to encourage its simplified registration. There is still a long-way to go because many key problems and puzzles about technology, registration and administration in cTCMeP R&D process are not resolved. Based on the analysis of registration and management regulations of botanical drug products in FDA of USA and Japan, and EMA of Europe, the possible key problems and countermeasures in chemistry, manufacture and control (CMC) of simplified registration of cTCMeP were analyzed on the consideration of its actual situation. The method of "reference decoction extract by traditional prescription" (RDETP) was firstly proposed as standard to evaluate the quality and preparation uniformity between the new developing product under simplified registration and traditional original usages of cTCMeP, instead of Standard Decoction method in Japan. "Totality of the evidence" approach, mass balance and bioassay/biological assay of cTCMeP were emphatically suggested to introduce to the quality uniformity evaluation system in the raw drug material, drug substance and final product between the modern product and traditional decoction., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Chinese Pharmaceutical Association.)

Paragonimus infection was reported in a family of 8 members after consuming wine-preserved raw crabs. Seven members developed symptoms of fever, cough, sputum, fatigueness, chest pain, and abdominal pain during 2-3 months after crab feeding, while one member was normal. Serum samples were collected from the 7 members for anti-paragonimus antibody test, with 5 members showing positive, 1 weakly positive and 1 negative. In view of the epidemiological history, clinical symptoms, imaging and laboratory test results, this case was diagnosed to be a family-clustered paragonimus infection.

Objective: To identify two suspected Trypanosoma species in Rattus found in Zhejiang Province using microscopy and PCR method., Methods: Blood samples were collected from Rattus losea and R. flavipectus. Blood smears were prepared, and observed under microscope. The morphological indices of trypanosomes were measured and calculated. The genomic DNA was extracted from the trypanosomes, and the specific fragment of Trypanosoma 18S rRNA gene was amplified using PCR. The products were further sequenced and submitted to GenBank. Blast analysis was performed on line in NCBI., Results: Blood samples from Ratts flavipectus and R. losea were collected from Lucheng District and Wencheng County of Wenzhou, respectively. The parasites from R. losea and R. flavipectus were found to possess the characteristic features of Trypanosoma species, such as nucleus, free flagellum, and kinetoplast, etc. The body length was 27.50 µm and 23.80 µm, and the free flagellum length was 9.60 im and 9.20 jim, respectively. The nucleus index was 0.74 and 1.05, the kinetoplast Index was 1.40 and 1.57, respectively. Based on the morphological characteristics and host specificity, the parasites from R. losea and R. flavipectus were identified as Herpetosoma species, mainly found in rodents. The amplified products were about 700 bp by 18S rRNA gene PCR with the DNA isolated from the trypanosomes. The products were further sequenced, and the resulting sequences were submitted to GenBank with assession numbers of KP098535 (from R. losea) and KP098536 (from R. flavipectus). Blast analysis showed that KP098535 was completely homologous with the sequences from Herpetosoma subgenus (AY491765.1, AY491764.1, and AJ223568.1), and KP098536 was completely homologous with Trypanosoma lewisi (AB242273.1, AJ009156.1)., Conclusion: The Trypanosoma species found from Rattus flavipectus is Trypanosoma lewisi, and the other one belongs to Herpetosoma subgenus, which may be named as Trypanosoma lewisi-like trypanosome.

A total of 258 malaria cases with 2 deaths were reported during 2007-2014, including 148 vivax malaria cases, 106 falciparum malaria cases, and 4 ovale malaria cases. During 2007-2009, 86.0% (135/157) were vivax malaria cases with 3 indigenous cases. In 2010-2014, the proportion of falciparum malaria is increasing year by year, and all were imported cases. 98.8% were imported from Africa and other provinces in China. Most cases occurred among patients aged 20-49 years, and the male-to-female ratio was 3.16:1. Most patients were workers and commercial service personnel. The malaria epidemic situation is relatively stable in Wenzhou. Malaria control and elimination interventions should emphasize the monitoring and education of transient population to control the imported cases, and explore multi-sector coordination for malaria prevention and control.

Objective: To understand the characteristics of malaria prevalence in Wenzhou City in 2013, so as to provide the evidence for improving the elimination program of malaria., Methods: The epidemiological data of malaria in Wenzhou City in 2013 were collected from the Chinese information system for disease control and prevention, and analyzed with the descriptive epidemiological methods for epidemiological characteristics of malaria., Results: Totally 34 imported malaria cases were reported in Wenzhou City in 2013 with the incidence of 0.37 per 100,000 people. Plasmodiumfalciparum, P. ovale and P. vivax were identified in 31, 1 and 2 cases, respectively. No death cases were reported, and 64.71% (22/34) of the cases were reported in Cangnan County, Lucheng District and Rui' an City. The malaria cases were mostly concentrated in persons aged 20-49 years with male to female sex ratio at 4.67: 1, and the predominant portion of cases were workers and commercial service personnel. Totally 97.06% of the cases were imported from Africa., Conclusions: The malaria endemic situation is relatively stable and no local malaria cases are reported in Wenzhou City in 2013. In order to achieve the goal of malaria elimination, the management and education of the transient population should be strengthened.

Objective: To investigate the protective effect and mechanism of Shenqi Compound on diabetic angiopathy modeled rats., Methods: Totally 18 SD rats were randomized into 3 groups, i.e., the normal control group, the diabetic mellitus (DM) group, and Shenqi Compound group, 6 in each group. The DM rat model was established by feeding high-fat diet (to induce hyperlipidemia) +intraperitoneal injection of small dose streptozotocin (STZ). Shenqi Compound was given to rats in the Shenqi Compound group at the daily dose of 2 g/kg. Equal volume of normal saline was given to rats in the model group and the normal control group by gastrogavage. All treatment was lasted for 12 weeks. Then 2-D and ultrasonic integrated backscatter technique were used to evaluate structural and functional changes of abdominal aorta in the progression of diabetic macroangiopathy. The fibrosis degree of the aorta vessel and myocardium capillaries were observed by using HE and Masson trichrome staining. The tension of the aortic vascular ring was determined. The transforming growth factor beta (TGF-beta) mRNA expression was detected by real time PCR (RT-PCR). The protein expression of TGF-beta, collagen I, collagen III, connective tissue growth factor (CTGF), and phosphorylation P38 MAPK were detected by Western blot., Results: Compared with the normal control group, abdominal aortic systolic inner diameter, diastolic inner diameter, Peterson elastic modulus, stiffness index, and backscatter integral significantly increased; the rangeability of integral backscatter and the extension coefficient of cross section significantly decreased in the DM group (all P < 0.05). After 12 weeks aforesaid indices were obviously improved in the Shenqi Compound group (P < 0.05). Results of HE and Masson staining showed that the fibrosis degree of the aorta vessel and myocardium capillaries was obviously alleviated in rats of the Shenqi Compound group (P < 0.05). Results of the aortic vascular ring tension showed that acetylcholine induced vasodilatation and maximum diastolic percent were obviously elevated in the Shenqi Compound group (P < 0.05). Compared with the normal control group, the mRNA expression of TGF-beta, and the protein expression of TGF-beta, collagen I, and collagen III, and phosphorylation of P38 MAPK all significantly increased in the DM group (P < 0.05). Compared with the DM group, the mRNA expression of TGF-beta, and the protein expression of TGF-beta, collagen I, and collagen III, and phosphorylation of P38 MAPK all decreased (P < 0.05)., Conclusions: Shenqi Compound could effectively improve the arterial function in diabetic marcoangiopathy and microvascular dysfunction. The mechanism might be due to the down-regulating the expression of TGF-beta, and further suppressing the phosphorylation of P38 MAPK, reducing the synthesis of collagen I and collagen III, therefore, ameliorating arterial and myocardial interstitial fibrosis.

Objective: To assess the appropriateness of breast cancer screening technologies in Guizhou province., Methods: We conducted a questionnaire survey, physical examinations, and high-frequency color Doppler ultrasound examinations in 20 183 women from 2010 to 2012 in Guizhou province. Biopsy was performed in those with suspected breast cancers., Results: The participants included 12,089 women who received repeated screening and 8,094 women who were given the screening service for the first time. Ten from the former group were identified with breast cancer (82.7/100 thousand), with the majority (80%) at an early stage. Eleven from the latter group were identified with breast cancer (135.9/100 thousand), 36.4% of whom being at an early stage. This resulted in a detection of 104 per 100 thousand breast cancers, with 57.1% at an early stage (0, I stage). The age of the women with breast cancer ranged from 35 to 80 years old. The prevalence peaked at 41-60 years of age, with 71.4% (15/21) falling into this age group (P < 0.05). Solid and cystic masses were found in 246 participants, with a minimum mass of 0.2 cm x 0.3 cm. Of the 228 participants diagnosed with benign masses, 225 (98.7%) were confirmed by biopsy results. The biopsy also confirmed 6 precancerous lesions., Conclusion: Guizhou had a prevalence of breast cancer of 104/100 thousand, which peaked at 41-60 years old. The screening method used in this study is appropriate.

Objective: To evaluate the quality of life and influencing factors on patients with multiple myeloma (MM)., Methods: 227 MM cases were selected at 5 hospitals in Xi'an from August, 2010 to March, 2013. QLQ-C30 was used to evaluate the quality of life of MM patients, and their norms were as control. Factors which influencing the quality of life were investigated and analyzed with SPSS 17.0 software., Results: The total score of quality of life in MM patients was 49.0±21.7 which was lower than the norms (60.7±23.4). The scores on fatigue, nausea, vomiting, pain, short of breath, disturbance on sleeping, losing appetite, constipation, other symptoms and financial difficulty were significantly higher than data of the norms (P < 0.05). Factors as being elderly (especially those older than 70), under higher proportion of medical costs on their own expense or financial difficulty etc., had major influences on the quality of life (P < 0.05) of MM patients who in particular having worse quality of life when in worsening clinical ISS stage (P < 0.05). Low level of hemoglobin, high level of serum calcium and globulin all significantly reduced the quality of life of the MM patients (P < 0.05)., Conclusion: The quality of life of MM patients was significantly lower than the normal people or patients with other tumors. Fatigue, pain, and financial difficulty were main influencing factors on the quality of life of MM patients. The assessment on the effects of treatment should relate to the improvement of hemoglobin, serum calcium and globulin, which could all improve the quality of life of MM patients.

The first imported case of Plasmodium ovale infection in Wenzhou City was confirmed by microscopy and PCR test. The patient returned from the People's Republic of Congo to Wenzhou for three and a half months presented a history of fever with chills and rigors on April 30, 2012. The results from peripheral blood smear examination and PCR analysis confirmed a diagnosis of P. ovale infection. The patient was treated with chloroquine plus primaquine for eight days and the symptoms improved.

Objective: To observe the clinical effects of Qiyao Xiaoke Capsule (QXC) on patients with type 2 pre-diabetes., Methods: Totally 116 pre-diabetes patients were randomly assigned to the Chinese medicine group (CM, 76 cases) and the blank control group (BC, 40 cases) in the ratio of 2: 1. All patients received proper diet control, health education, and exercises, and so on. Besides, patients in the CM group took QXC (0.4 g/pill), 6 pills each time, three times a day. But patients in the BC group were intervened by life style alone. The fasting blood glucose (FBG), postprandial blood glucose (PBG), insulin (FINS, 2h INS), glycosylated hemoglobin (HbAlc), blood lipids (TG, TC, HDL-C, and LDL-C), and efficacy of CM symptoms were observed in the two groups before and after intervention. The sequelae were observed at the end of the treatment and at follow-ups., Results: After treatment FBG, PBG, and HbA1c decreased in all patients of the two groups (P<0.05, P<0.01), with 2 h PBG decreased more significantly. But there was no statistical difference between the two groups (P>0.05). The two methods could improve the secretion of FINS. Especially 2 h INS decreased more significantly in the CM group, showing statistical difference when compared with the BC group (P<0.05). The two methods could improve the metabolism of blood lipids. CM could significantly lower TG and elevate HDL-C, showing statistical difference when compared with before treatment (P<0.05). After treatment the CM symptoms were obviously improved, showing statistical difference when compared with the BC group (P<0.05). The normalization rate was better in the CM group than in the BC group at the end of the treatment and at follow-ups (P<0.05)., Conclusions: QXC combined life style intervention could improve fasting and postprandial insulin secretion of type 2 pre-diabetes patients, regulate glycolipid metabolism, correct the insulin resistance state, and improve the symptoms of qi-yin insufficiency. It could postpone or hinder the occurrence and development of type 2 diabetes. It was more effective and durable than changing the life style alone.

Objective: To evaluate the necessity of splenectomy in radical resection of gastric cancer., Methods: Twelve studies comparing outcomes after radical resection of gastric cancer with or without splenectomy were identified. Both fixed effect model and random effect model were used., Results: There were 2628 patients in total. There were significant differences in complications between splenectomy group and spleen-preserving group(OR=1.91, 95% CI:1.28-2.87, P<0.05), while no significant difference in 5-year survival rate was noticed(HR=0.90, 95% CI:0.73-1.11, P>0.05)., Conclusion: Radical resection of gastric cancer combined with splenectomy is not associated with improved survival but increased postoperative complications.

Rhesus macaque (Macaca mulatta) has long been used as an experimental model animal for biomedical research and was under the key state protection (class II) from Chinese government. In order to facilitate the use of Chinese rhesus macaques in biomedical research and their protection based on better understanding of the major mistocompability complex (MHC) genes in these macaques, the exon 2 of Mamu-DPB1 genes were determined in 106 wild rhesus macaques using DGGE, cloning and sequencing. A total of 21 Mamu-DPB1 alleles were obtained, of which 15 alleles were novel sequences that had not been documented previously. Mamu-DPB1 30 was the most frequent allele in the whole large population comprising all 106 rhesus macaque individuals (0.1120) and in Xiaojin population (0.1120), Mamu-DPB1 04 in Heishui (0.1702), -DPB1 32 in Bazhong (0.1613), -DPB1 30 in Hanyuan (0.1120), and -DPB1 04 in Jiulong (0.1139). The alignment of the amino acids sequences showed that 12 variable sites were species-specific, of which 9 sites occurred in the putative amino acids sequences of the 15 novel Mamu-DPB1 alleles. Trans-species polymorphism was observed on the phylogenetic tree based on the DPB1 alleles of rhesus macaques and cynomolgus (Macaca fascicularis). In addition, these results also demonstrated that significant genetic differentiation has occurred between Chinese and Indian rhesus macaque population.

Objective: To investigate the expression of glucose transporter 1 (Glut1) in human breast cancer and its relationship to proliferating cell nuclear antigen (PCNA) protein, other tumor biomarkers and clinical pathologic factors., Methods: Imunohistochemical staining (SP) was applied to measure the expression of Glut1 and PCNA in 20 cases of human breast fibroadenoma, 20 cases of usual hyperplasia and 80 cases of breast carcinoma., Results: Glut1 was not found expressing in breast fibroadenoma and hyperplastic lesions. In contrast, the total positive rate of Glut1 in breast carcinoma was 58.8% (47/80); that in the ductal carcinoma in situ (DCIS) was 45.0% (9/20), that in the well-differentiated invasive carcinoma was 50.0% (15/30) and that in the poorly differentiated was 76.7% (23/30). The total positive rate of PCNA in breast carcinoma was 75% (60/80), that in DCIS was 65% (13/20) and that in invasive carcinoma was 78.3% (47/60). There was a positive correlation between Glut1 and PCNA level (r = 0.742, P (< 0.01)., Conclusion: The overexpression of Glut1 play important roles in carcinogenesis and progression of breast carcinoma and closely correlate with cell proliferation of breast carcinoma, may suggest different therapeutic approaches or the need for closer follow-up, and be wished to become a new target for treatment of breast carcinoma.

Objective: To investigate the protective effects of Tangxinping Capsule, a compound traditional Chinese herbal medicine, on diabetic cardiomyopathy in rats., Methods: The model of diabetes mellitus was induced by streptozotocin (STZ) injection in rats. And the rats with diabetes mellitus were randomly divided into untreated group, metformin group, captopril group, and low-, medium- and high-dose Tangxinping group; the other ten normal rats were used as normal controls. After eight-week treatment, all rats were sacrificed to detect angiotensin II (Ang II) protein content and angiotensin II type 1 receptor (AT1R) mRNA expression in myocardial tissues by radioimmunoassay and reverse transcription polymerase chain reaction (RT-PCR) respectively. The ultrastructural change in myocardial tissues was detected by transmission electron microscopy., Results: The results of radioimmunoassay and RT-PCR showed that the content of Ang II protein and the expression of AT1R mRNA in myocardial tissue of the untreated group was significantly increased and more than those in normal control (P<0.05, P<0.01). Only the content of Ang II and expression of AT1R mRNA in high-dose Tangxinping group and captopril group were significantly lower than those in the untreated group (P<0.05, P<0.01). The transmission electron microscopy showed that volume of mitochondrion in myocardial tissue in the untreated group was bigger than that in normal control group. Also the volume of mitochondrion was improved in 5 treated groups, but had no significant difference when compared with the untreated group., Conclusion: Tangxinping may adjust the disorder of renin-angiotensin system to protect myocardial tissue in rats with cardiomyopathy due to diabetes.

Objective: To evaluate the effects of traditional Chinese medicine in 461 cases of severe acute respiratory syndrome(SARS) on glucocorticoid's dosage., Method: By using the polycentric nonrandomized concurrent controled trial and under the condition of glucocorticoid use, the patierts were divided into two groups: the integrated traditional Chinese and western mendicine(ITCWM) and simplicity western mendicine alone(WM). The observation indexes were time in hospital, pneumonia duration, mortality, glucocorticoid's gross dosage, glucocorticoid's average dosage of days and glucocorticoid use time., Result: In the ITCWM group, average time in hospital was shortened (P = 0.058), pneumonia duration was shortened (P = 0.057), mortality fell (P = -0.001). The median of glucocorticoid' s gross dosage was 1,277.0 mg x d(-1) in the ITCWM group, and that was 1,680.0 mg x d(-1) in the WM group (P = 0.083). The median of glucocorticoid's average dosage of days was 84.40 mg x d(-1) in the ITCWM group, and that was 115.33 mg x d(-1) in the WM group (P = 0.025). According to the analysis of 461 cases divided by stages and different ponderance, within 7 days after illness, in the ITCWM group, the glucocorticoid' s average dosage decreased. In the common type, the dosage in the ITCWM and in the WM was 146.43 mg x d(-1), and 183.64 mg x d(-1), respectively (P = 0.057), in the severe type, that was 137.71 and 177.86 mg x d(-1), respectively (P = 0.001)., Conclusion: Compared with the group of simplicity western mendicine, in the group of integratived Chinese and western mendicine, time in hospital shorten, pneumonia duration shorten, mortality fall, simultaneity, glucocorticoid's average dosage is decreased. The use of TCM in the forepart of treatment can be capable of decreasing glucocorticoid's dosage.